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Medicare Basics Overview

Medicare is a federal program, managed by the Centers for Medicare & Medicaid Services. It provides health insurance to eligible United States citizens and permanent residents of five or more years.

You’re eligible for Medicare if you’re 65 or older, or under 65 with certain disabilities. You may also qualify for Medicare, regardless of age, if you have end-stage renal disease requiring dialysis or a kidney transplant, or amyotrophic lateral sclerosis (also known as Lou Gehrig’s Disease).

Medicare overview

Medicare beneficiaries can generally get their health coverage in two ways: through Original Medicare, or through a private Medicare health plan, such as Medicare Advantage. Original Medicare comes in two parts:

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  • Medicare Part A (hospital insurance):  This covers inpatient hospital, skilled nursing facility, hospice, and home health care.
  • Medicare Part B (medical insurance): This covers outpatient medical care, including doctor’s visits, durable medical equipment, lab tests, and preventive services.

Certain types of Medicare coverage are only available through private insurance companies. This includes:

  • Medicare Part C (Medicare Advantage): Medicare Advantage provides Original Medicare benefits through a private health plan, such as a Preferred Provider Organization plan or Health Maintenance Organization plan. In addition to what’s covered under Original Medicare, some plans offer other benefits, such as routine dental and vision, health wellness programs, and prescription drug coverage.
  • Medicare Part D (prescription drug coverage): Original Medicare doesn’t include prescription drug benefits, except in certain situations. You can sign up for prescription drug coverage through a separate Medicare prescription drug plan, or through a Medicare Advantage Prescription Drug plan.
  • Medicare Supplement (Medigap): Medigap helps pay for out-of-pocket costs in Original Medicare, such as copayments, coinsurance, deductibles, and overseas health coverage. These plans can only be used for Original Medicare costs.

If you’re enrolled, or will soon be eligible for Medicare, and are considering whether one of the private insurance plans could be a good option for you, I can help you check those out. To learn more about who I am, click on the orange button underneath my photo below and check out my profile. I’m happy to walk you through your options by phone or email you information; you can request that using the links below. To compare your options right away, click the blue Find Your Plan button near the top-right side of this page and view the plans offered by insurance companies in your area. If you’d like to get personalized assistance, talk to me or another eHealth agent by dialing 1-844-847-2659 (for TTY, 711).

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